Never allow your wanton desires to interfere with the basic needs and interests of others and live simply so others may simply live

Tuesday, August 13, 2013

From the New York Times (Children with Chronic Stomach Pain)

The following article features a study by my good friend Lynn Walker, Director of the division of
adolescent health at Monroe Carell Jr. Children’s Hospital at
Vanderbilt and senior author of the study.

Risk of Adult Anxiety Seen in Children’s Stomachaches

Christopher Berkey for The New York TimesDonya Kazemi, 11, right, with her mother, Nasrin, and sister, Diana, 15, has functional abdominal pain.

Children with chronic stomach pains are at high risk for anxiety disorders in adolescence and young adulthood, a new study has found, suggesting that parents may wish to have their children evaluated at some point for anxiety.

Researchers at Vanderbilt University tracked 332 children with
recurring stomachaches that could not be traced to a physical cause —
so-called functional abdominal pain — comparing them as they reached
young adulthood with 147 children who had never had such stomachaches.

About half the teenagers and young adults who had had functional
abdominal pain as children developed an anxiety disorder at some point,
compared with 20 percent of the control group, the researchers found.
The vulnerability to anxiety persisted into adulthood even if the pain
had disappeared, although the risk was highest if the pain continued.

Forty percent of the children with functional abdominal pain went on
to experience depression, compared with 16 percent of those who had
never had these stomachaches.

The study was published on Monday in the journal Pediatrics.

“What this study shows is a strong connection between functional
abdominal pain and anxiety persists into adulthood, and it drives home
the point that this isn’t by chance,” said Dr. John V. Campo, chairman
of the department of psychiatry at Ohio State University, who was not
involved in the new study.

In 2001, Dr. Campo published a smaller study
that found that 28 young adults who had suffered functional abdominal
pain as children were far more likely to have an anxiety disorder than
28 similar adults who had experienced another childhood illness.

Chronic abdominal pain affects 8 percent to 25 percent of school-age
children. The problem can lead to school absences and take a toll on
families.

“Somebody might say, ‘Of course they have mental issues or they are
emotionally distressed — it’s because of the pain,’ ” said Lynn S. Walker, senior author of the study and director of the division of
adolescent health at Monroe Carell Jr. Children’s Hospital at
Vanderbilt.

“But we found even if the pain went away, these adolescents and young
adults still have anxiety,” Dr. Walker said. “So maybe we need to treat
their anxiety.”

The state-of-the-art treatment for functional abdominal pain is
rehabilitative, focused on getting patients to participate in daily
activities despite their stomachaches. “There’s no question that there
are triggers for the pain, but the problem is in the perception of the
pain and adaptation to the pain,” said Dr. Samuel Nurko, director of a
functional abdominal pain center at Children’s Hospital Boston.

Dr. Nurko compared the pain to a light on a dimmer switch, which
psychological techniques can help children control. “You don’t take away
the pain,” he said. “You ‘dim’ it to be able to cope better.”

The new study underscores the importance of screening children with
the condition for anxiety or depression, the authors said. Anxious
children tend to be good children who are concerned about doing their
best, Dr. Walker said, and parents may be flummoxed by the suggestion
that such a child could be grappling with a mental health issue.

The majority of the children enrolled in the study “had not seen a mental health professional, ever,” Dr. Walker said.

But Miranda van Tilburg, an associate professor of medicine at the
University of North Carolina School of Medicine, cautioned parents
against leaping to the conclusion that a child’s unexplained stomach
pain is “all anxiety based, because we don’t know that.”

“The take-away message should be you should not be afraid, if your
doctor talks to you about anxiety in your child, to seek help from a
mental health professional, because it could help your child feel
better,” Dr. van Tilburg said.

Such a referral is “not an admission that that’s what’s causing the
pain,” she said. “It’s just an admission that anxiety is linked to the
pain.”

Nasrin Kazemi, a part-time real estate agent in Brentwood, Tenn., has
three children, all of whom had frequent stomachaches. “If I get a
little more excited, or sad, or mad about something, my stomach will
start hurting,” said Mrs. Kazemi’s youngest daughter, Donya, 11.
The anticipation of starting sixth grade this fall has set off new
waves of stomach pain. “It’s probably not going to stop until I get used
to sixth grade,” Donya said.

She became anxious two years ago after a ghastly fortnight of
flu-induced vomiting, her mother said. Since then, Donya worries about
attending birthday parties where she might catch another flu, and such
concerns make her abdominal pain flare up.

At first, Mrs. Kazemi was reluctant to seek psychological help for
Donya, but her daughter eventually saw Dr. Walker. Mrs. Kazemi is
hopeful about the new research, even though it suggests that Donya may
have a lifelong vulnerability to anxiety.

“Because she is learning to deal with her emotions and to not let
them get the better of her, she’ll be better with dealing with negative
things that happen later in life,” Mrs. Kazemi said.

2 comments:

I don't think it is surprising in the least that many children today suffer with anxiety. If they ever turn on a television or computer, listen to certain genres of music, or are buffeted about in the public school system; not to mention exposure to adult anxiety and themes, advertising, financial woes, oh my, the list goes on, doesn't it!

I'm sure it is a complicated chicken and egg problem. But, it seems to me that anxious parents might unwittingly pass that to their children who then display the symptoms. I think some parents also have unrealistic expectations for their children and such pressure can show up in unhealthy ways in the child....I am sure children can be helped by gaining an understanding of their symptoms and gain some control over them, but still the dysfunctional context (family/community) has to be addressed as well. I am no expert on these things, just my passing thoughts here.

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